scholarly journals Analysis of Caesarean-Section rates according to Robson's ten group classification system and evaluating the indications within the groups

2017 ◽  
Vol 6 (2) ◽  
pp. 447 ◽  
Author(s):  
Amita Ray ◽  
Sumy Jose
Keyword(s):  
Classification System ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Health Care Facilities ◽  
Care Hospital ◽  
Cross Sectional ◽  
The Absolute ◽  
Group 5 ◽  
Group 2

Background: With Caesarean sections on the rise WHO proposes that health care facilities use the Robson's 10 group classification system to audit their C-sections rates. This classification would help understand the internal structure of the CS rates at individual health facilities identify key population groups, indications in each group and formulate strategies to reduce these rates.Methods: This was a cross sectional study for a period of 24 months at a tertiary care hospital in a tribal area of Kerala South India. Women who delivered during this period were included and classified into 10 Robson's classes and percentages were calculated for the overall rate, the representation of groups, contribution of groups and Caesarean percentage in each group.Results: Highest contribution was by Group 5 and Group 2. Together these two groups contributed to 38% of the total Caesareans. Followed by Group 8 and 10. All four added contributed to 63% of the section rate The least contribution was by Group 3. Groups 6, 7 and 9 by themselves did not contribute much but within their groups had a 100% C-Section rate.Conclusions: The contribution of the various Robson's Group to the absolute C-Section rates needs to be looked into. Reducing primary section rates, adequate counselling and encouraging for VBAC, changing the norms for dystocia and non-reassuring fetal status, training and encouraging obstetricians to perform versions when not contraindicated could reduce the contribution of Robson's groups towards the absolute C-Section rates.

scholarly journals Classification of births according to Robson 10 group classification: an emerging concept to audit the increasing caesarean section rate

2019 ◽  
Vol 8 (10) ◽  
pp. 3915
Author(s):  
Priyanka Kolusu ◽  
Palutla Himabindu
Keyword(s):  
Caesarean Section ◽  
Care Center ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Health Care Facilities ◽  
Health Concern ◽  
Cross Sectional ◽  
Group 5

Background: High caesarean birth rates are an issue of international public health concern. Worries over such increases have led the WHO to advice that caesarean section rate should not be more than 15%. WHO proposes that the health care facilities to use the Robson’s 10 group classification system to audit their CS rates. Our aim was to investigate the CS rates in a period of 6 months using Robso’s 10 group classification.Methods: This was a cross sectional study conducted for a period of 6 months from July 2018 to December 2018 in Department of Obstetrics and Gynecology, Siddhartha medical college which is a tertiary care center .All women delivered during this period in labour ward were included. All relevant obstetric information (parity, mode of previous deliveries, previous CS and indications, gestational age, onset of labor) was entered on a questionnaire and classified into Robson’s 10 classes and percentages were calculated.Results: Total number of deliveries in 6 months is 4719 out of which C-sections are 1816 which accounts for 38.48%. Highest contribution was by group 5 and group 2. Together these two groups contribute to 62.4% of the total caesarean sections. Group 6 and group 9 by themselves did not contribute much but within their groups had 100% C-section rates.Conclusions: Robson’s 10 group classification provides easy way in collecting information about caesarean section rate which obtains good insight into certain birth groups. Number of women who attempt VBAC has declined over recent years due to fear of uterine rupture. Reducing primary C-section rates, adequate counseling and changing norms for non-reassuring fetal status could reduce contribution of Robson’s groups towards absolute C-section rates.

scholarly journals Auditing the cesarean section rate by Robson’s ten group classification system at Tertiary Care Hospital.

2020 ◽  
Vol 27 (04) ◽  
pp. 700-706
Author(s):  
Mehak Asim Khan ◽  
Irum Sohail ◽  
Maria Habib
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Tertiary Care ◽  
Population Based ◽  
Group Classification ◽  
Care Hospital ◽  
Cross Sectional ◽  
Lower Segment Cesarean Section ◽  
Gynecology And Obstetrics ◽  
Group 5

Objectives: To analyze the trends of cesarean sections, categorize them into Robson’s Ten Group Classification System (RTGCS), to identify the groups contributing the most to overall lower segment cesarean section (LSCS) rate and to formulate strategies for reducing these rates. Study Design: Cross sectional population based study. Setting: Gynecology and Obstetrics Department of Kahuta Research Laboratories (KRL) hospital, Islamabad. Period: From 1st Nov, 2017 to 30th April, 2018. Material & Methods: The births during this period were distributed into the RTGCS on the basis of past obstetric history and fetal characteristics along with mode of onset of labour. Overall LSCS rate was calculated and contribution of each group was analyzed separately by SPSS version 23. Results: Our study showed 617 LSCS out of 964 deliveries making a high LSCS rate of 64%. Group 5, 2 and 10 of RTGCS contributed to the majority of LSCS performed with the percentages of 47.5%, 18.5% and 12.8% respectively. Group 5 of RTGCS which contributed to the highest LSCS rate had 354 subjects which were previous scars out of which 199 had previous 1 scar making the percentage 56.21%. It contributed 32.3% to the overall LSCS rate. Conclusion: RTGCS is a very useful tool for auditing the LSCS rate at local, national and international levels. Once the LSCS are classified into specific RTGCS, analysis can be done about the reasons for the increasing rates of LSCS and then strategies can be devised to reduce them.

scholarly journals Use of the Robson classification to assess caesarean section trends in tertiary hospital

2018 ◽  
Vol 7 (5) ◽  
pp. 1796
Author(s):  
Gomathy Gomathy E. ◽  
Kondareddy Radhika ◽  
Triveni Kondareddy
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Health Care Facilities ◽  
Care Hospital ◽  
Cross Sectional ◽  
Robson Classification

Background: With caesarean sections on the rise WHO proposes that health care facilities use the Robson's 10 group classification system to audit their C-sections rates. This classification would help understand the internal structure of the CS rates at individual health facilities identify key population groups, indications in each group and formulate strategies to reduce these rates.Methods: This was a cross sectional study for a period of 6 months at a tertiary care hospital in a rural area in Karnataka, South India. Women who delivered during this period were included and classified into 10 Robson's classes and percentages were calculated for the overall rate, the representation of groups, contribution of groups and Caesarean percentage in each group.Results: Highest contribution was by Group 5 and Group 2. Together these two groups contributed to 50.3% of the total Caesareans. Followed by Group 1 and 10. A Groups 6, 4, 8 and 9 by themselves did not contribute much but within their groups had a 100% C-section rate.Conclusions: Robson 10-group classification provides easy way in collecting information about Caesarean section rate which obtains good insight into certain birth groups. Reducing primary section rates, adequate counselling and encouraging for VBAC, changing the norms for non-reassuring fetal status, training and encouraging obstetricians to perform versions when not contraindicated could reduce the contribution of Robson's groups towards the absolute C-Section rates.

Analysis of Cesarean section delivery in Ain Shams University hospital according to the Robson’s 10-group classification system

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
MOHAMMED H SALAMA ◽  
AHMED M MOHAMMED ◽  
ASHRAF F NABHAN
Keyword(s):  
Classification System ◽  
Care Center ◽  
Tertiary Care ◽  
Maternity Hospital ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Health Care Facilities ◽  
University Hospital ◽  
Cross Sectional ◽  
Cesarean Section Delivery

Abstract Background Cesarean delivery is increasing worldwide in the last few years, unnecessary CS is a growing problem affecting both developed as well as developing countries. There is no benefits either to mother or neonate when the procedure is not medically indicated. The ideal rate of CS is considered between 10%-15%, beyond which there is no benefits for either mother or fetus. However recent studies showed a much higher rate of CS. WHO proposes that health care facilities use the Robson's 10 group classification system to monitor their CS rates. This classification helps to understand the internal structure of the CS rates at each health facilities, the indications in each group and formulate strategies to reduce these rates. Objectives the aim is to describe the frequency of CS delivery in Ain Shams University Maternity Hospital by Robson classification. And to describe maternal and neonatal outcomes. Methods The study was a descriptive cross sectional study conducted at labor ward of Ain Shams University Maternity Hospital (a tertiary care center). All women delivered by CS during a period of six months were recruited and classified into 10-Robson's groups. The overall CS rate were calculated, and also the contribution of each groups to the overall CS rate. Results The highest contribution to the overall CS was by group five 38.98%, followed by group ten 34.20%. While group 9 was lowest frequency 0.50% of overall CS rates. Conclusion s: The use of Robson’s classification system allows to monitor the CS rates which helps to identify the main contributors for the increasing CS rates, also helps to identify the target groups that may benefit from implementations of interventions for reducing CS rates. Women with previous CS were an important determinant of overall CS rates, reducing primary CS rates, counselling for VBAC, encouraging versions when available, could reduce the CS rates.

scholarly journals Analysis of caesarean section rate in tertiary care hospital according to Robson`s 10 groups classification

2018 ◽  
Vol 7 (4) ◽  
pp. 1380
Author(s):  
Varija T. ◽  
Veerendra Kumar C. M. ◽  
Chandrasekhar Tarihalli
Keyword(s):  
Caesarean Section ◽  
Classification System ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Case Series ◽  
Breech Presentation ◽  
Group Classification ◽  
Care Hospital ◽  
Case Series Study ◽  
Group 5

Background: The caesarean section (CS) delivery rate is steadily increasing worldwide, including India. Identifying the proportion of women in various categories as per Robson's ten group classification system and CS rate among them is important to bring down the increasing CS rate.Methods: This case series study was conducted at Vijayanagar Institute of Medical Sciences (VIMS), a tertiary care teaching hospital in Ballari, Karnataka, India. All pregnant women who have been admitted for delivery were enrolled and the data was collected for the women delivered by CS during January 2016 to December 2016 and proportions in various groups as per Robson’s ten-group classification system were calculated.Results: Among a total of 6980 women delivered during study period, 2992 (42.8%) delivered by CS. The CS rates among various groups varied from 100% among women with abnormal lies and group 6-95% (all nulliparous breeches) group 5-94% (Previous CS, single cephalic, >37 weeks) to 10 to 15% among multiparous women with spontaneous labour having single cephalic pregnancy (group 3). Among women with previous section, CS rate was very high (89.6%). Women with previous CS (group 5) contributed maximum (40.24%) to the total number of CS.Conclusions: In the present study, all women with breech presentation and abnormal lies delivered by CS and repeat CS was the highest contributor to all CS deliveries.

scholarly journals Analysis of Caesarean Section Rates Using the Robson Ten-group Classification at a Tertiary Care Teaching Hospital in Eastern India: A Cross-sectional Study

2021 ◽  
Author(s):  
Hiralal Konar ◽  
Madhutandra Sarkar ◽  
Sisir Kumar Chowdhury
Keyword(s):  
Caesarean Section ◽  
Tertiary Care ◽  
Relative Size ◽  
Group Classification ◽  
Cross Sectional ◽  
Care Teaching ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Introduction: The Robson ten-group classification identifies the women’s groups that make the greatest contribution to the overall rate of Caesarean Section (CS), and thereby helps to optimise CS rates. It also helps to ensure optimum maternal and perinatal outcomes. Aim: This study was undertaken to examine the rates of CS using the Robson ten-group classification, and also to identify the women’s groups that contribute most to CS rates in a tertiary care teaching and referral hospital in Kolkata, India. Materials and Methods: This cross-sectional observational study was conducted over a period of one year from May 2012 to April 2013. All pregnant women admitted under the supervision of a particular unit of the Department of Obstetrics and Gynaecology and delivered in that hospital during the study period were included. Necessary data collection was done on the following parameters, i.e., previous obstetric history, category of pregnancy, course of labour and delivery, and gestational age. The women were categorised into the ten Robson groups. For each group, the CS rate, relative size of the group, and the percentage contribution made by the group to the overall CS rate were calculated and expressed in percentages. Chi-square test, Z-test and the trial version of Statistical Package for Social Sciences (SPSS) version 20.0 were used to analyse the data. Results: The CS rate in the present study was 43.13% (735 out of 1704 deliveries). Not only the largest group in terms of relative size 649 (38.08%), the Robson group 1 had a CS rate of 41.75% (271/649), as well as the largest absolute number of caesarean deliveries. The group 1 made the largest contribution (271) to the overall CS rate (15.9%). The group 5 was the second largest contributing group 155 (9.09%), followed by group 3 96 (5.63%) and group 2 69 (4.04%). In the present study group 5 showed the CS rate of 95.67%, group 3 with CS rate of 24.48% and group 2 with CS rate of 60.52%. Conclusion: The Robson groups 1, 2, 3 and 5 were found to be the major contributors to the overall CS rate. These groups may be targeted for effective interventions to reduce the CS rate. Active management of labour in a primigravida with spontaneous onset, reduction of primary caesarean delivery, promoting vaginal birth after CS, and careful assessment of cases before induction of labour in nulliparous women, are likely to be few effective strategies.

scholarly journals Analysis of Cesarean Section at a Tertiary care centre in Eastern Nepal according to Robson's Ten Group classification System (TGCS): A hospital based cross sectional study.

2020 ◽  
Vol 5 (3) ◽  
pp. 1171-1175
Author(s):  
Anamika Das ◽  
Ajay Agrawal ◽  
Sangeeta Bhandari ◽  
Sanyukta Rajbhandari ◽  
Surya Prasad Rimal
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Tertiary Care ◽  
Relative Size ◽  
Group Classification ◽  
Health Care Facilities ◽  
Cesarean Section Rate ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
The Absolute

Introduction: Cesarean sectionis on the rising trend,so WHO proposes that health care facilities uses the Robson's 10 group classification system to audit their Cesarean section rates. This classification will helpto developstrategies to reduce these rates. Objective: The objective of this study was to classify the women coming for delivery into the 10 Robson’s group,to interpret the 10 group classification and to know the highest rate of cesarean section in the group. Methodology: This was a hospital basedcross sectional study carried out in the Department of Obstetrics and Gynaecology, for a period of 6months. All women undergoing deliverywere recruited for study .Based onthe  patient’s obstetric parameters, women were assigned to one of 10 groups as per Robson’s 10-group classification system.The relative size of each group, the cesarean section rate in each group, and the absolute and relative contributions to the overall cesarean section rate was then reported. Results: During the study period, the overall Cesarean Section rate was 33.40%.Highest contribution was by Robson's Group 2(Nulliparous, single cephalic, ≥ 37 weeks, induced or CS before labor(9.84%) followed by Group 1(Nulliparous, single cephalic, ≥ 37 weeks, in spontaneous labor)(7.73%) and Group 5(Previous CS, single cephalic, ≥ 37 weeks)  (5.75%). Least contribution was by Groups 8(All multiple pregnancies (including previous CS)and 9[All abnormal lies (including previous CS)]0.20% and 0.27% respectively. All women in group 9(all abnormal lies including previous CS)had 100% Cesarean rate. Conclusions: With reductions in the primary cesarean section rates and encouragingpatients forVBACcould reduce the contribution of Robson's groups towards the absolute Cesarean Section rates.

scholarly journals Robson’s Group 2 Criteria among Total Caesarean Sections in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (243) ◽  
pp. 1098-1101
Author(s):  
Pratigyan Gautam ◽  
Chanda Karki ◽  
Asmita Adhikari
Keyword(s):  
Caesarean Section ◽  
Confidence Interval ◽  
Cesarean Section ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Group 2

Introduction: Globally, there is a dramatic rise in cesarean section rate which has increased the maternal morbidity and adverse effects in a subsequent pregnancy. Robson’s classification will aid in the optimization of the cesarean section use, assessment of the strategies aimed to decrease the cesarean section rate and thus improve the clinical practices and quality of care in various health care facilities. The main aim of this study is to find out the prevalence of caesarean section for Robson’s group 2 among total caesarean sections done in a tertiary care hospital. Methods: A descriptive cross-sectional study was carried out at a tertiary care centre in Nepal from August 2020 to January 2021. Ethical approval was taken from the institutional review committee (reference number: 1607202003) and data were entered using Robson’s criteria. The convenient sampling technique was used. Data was analyzed using Microsoft Excel. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: According to Robson’s group 10 classification, among 380 caesarean sections, 110 (28.94%) (24.38-33.50 at 95% Confidence Interval) cases were in Robson’s group number 2. Conclusions: This study showed that the prevalence of caesarean section which lies in Robson’s group 2 in our study is higher than the standard of World Health Organization. It showed that Robson’s group 2 was one of the significant contributors to the greater caesarean section rate. Improved case selection, standardization, and protocol for induction of labour as well as regular audit could also reduce caesarean section rates.

scholarly journals Using the Robson Classification to Explain the Fluctuations in Cesarean Section

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
H. Cammu ◽  
E. Martens ◽  
G. Van Maele
Keyword(s):  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Induced Labor ◽  
Robson Classification ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
The Absolute ◽  
Group 5 ◽  
Group 2

Purpose. As the rate of cesarean sections (CS) continues to rise in Flanders (northern part of Belgium), it is important to understand the reasons behind this evolution and to find ways to achieve appropriate CS rates. For this analysis, we categorized CS changes between 1992 and 2016, applying the Robson 10-Group Classification System (TGCS). We also applied the TGCS to analyze the information of the only clinics where between 2008 and 2016, the absolute CS rate had fallen by more than two percent. Methods. This paper is based on a population-based cross-sectional study. Robson’s TGCS was used to analyze CS rates for the years 1992, 2000, 2008, and 2016, using the Flemish population-based birth register. Results. Between 1992 and 2016, the overall CS rate increased from 11.8% in 1992 to 20.9% in 2016. The major contributors to that increase were (a) single, cephalic nulliparous women, at term in spontaneous labor (Robson group 1); (b) single, cephalic nulliparous women, at term in induced labor or CS before labor (group 2); and (c) multiparous women with single cephalic at term pregnancy with history of CS (group 5). In the subgroup of the seven clinics where the collective CS rate had decreased from 23.2% in 2008 to 19.3% in 2016, the main contributors to this decrease were Robson groups 1 and 2. Conclusions. The CS increase in Flanders between 1992 and 2016 is mainly the result of the absolute CS increase in the childbirth of nulliparous women with a single cephalic baby at term in spontaneous or induced labor and in women with a single cephalic presentation at term and a previous CS. Further research in these aforementioned groups is needed to identify the real reasons for the CS increase.

Analysis of caesarean section rates using Robsons ten group classification: the first step

2017 ◽  
Vol 6 (8) ◽  
pp. 3481 ◽  
Author(s):  
Sowmya Koteshwara ◽  
Sujatha M. S.
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Cross Sectional ◽  
Medical College ◽  
Relative Contribution ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Background: The Caesarean section (CS) rate is steadily increasing worldwide including India. The overall CS rates are reported but rarely the women are classified. According to WHO Robson ten –group classification is useful as a global standard for assessing, monitoring and comparing cesarean section rates. Our objective was to classify women delivering in our hospital according to various categories as per the 10-group classification (Robsons classification) and analyzing the CS rate in each group.Methods: This was a cross sectional study conducted at JSS Medical College, Mysore. The data was collected for all women delivering in hospital from January 2016-December 2016 and the women were classified according to Robsons 10 group classification. The proportion of women delivering in each group, the CS rate of each group, and the relative contribution to CS rate from each group was calculated.Results: Among a total of 5016 women delivering during the study period 37.65% of women were delivered by CS. Maximum no of pregnant women belonged to primigravida group (group 1 and 2). Major contributor to CS rate were primigravida (group 2) at 32.2%. Next contributors were group 5 and group 1 at 28.9 % and 18.6% respectively. Overall the three groups 1, 2 and group 5 contributed to 79.7% of the CS rate while the other group contributed to only 21.3% of CS rate.Conclusions: Applying Robsons criteria to classify pregnant women allowed for easy classification to identify the category of women most likely to have CS. Reducing primary CS rate and increasing VBAC rates will help to reduce CS rate. 

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